Provider Demographics
NPI:1487681169
Name:MCKAY, JAMES COLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:COLEY
Last Name:MCKAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 LAUREL WOOD DR
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5354
Mailing Address - Country:US
Mailing Address - Phone:336-627-4702
Mailing Address - Fax:336-627-1735
Practice Address - Street 1:319 HOSPITAL DR
Practice Address - Street 2:STE. 104
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1929
Practice Address - Country:US
Practice Address - Phone:276-638-1983
Practice Address - Fax:276-638-3736
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32144207RN0300X
VA0101044604207RN0300X
LAMD.07559R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-56963Medicaid
VA006068502Medicaid
NCD26896Medicare UPIN
NC89-56963Medicaid
NC204082Medicare ID - Type Unspecified
VA006068502Medicaid